Provider Demographics
NPI:1780860270
Name:RIGBY, MARYANNE SUSAN (MA)
Entity Type:Individual
Prefix:MS
First Name:MARYANNE
Middle Name:SUSAN
Last Name:RIGBY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CONEJO LN
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92833-1842
Mailing Address - Country:US
Mailing Address - Phone:714-773-1632
Mailing Address - Fax:
Practice Address - Street 1:101 S KRAEMER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6109
Practice Address - Country:US
Practice Address - Phone:714-577-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC45091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist